Tennessee Chiropractic Continuing Education

• Relate the effects of failure within the DNIC to the development of chronic pain.
• Draw the pathways specific to ascending sensory and descending pain modulatory circuits.
• Apply knowledge of the DNIC, as it relates to chronic lower back pain.
• Discuss basic science research that links the PAG with the phenomena of offset analgesia and conditioned pain modulation.
• Formulate and apply treatment plans based on stimulation of the DNIC utilizing spinal cord stimulation, motor cortex activation and heterotopic noxious conditioning stimulation.

• Relate the effects of cingulate cortex activation on chronic pain suppression.
• Draw and identify regions of the cingulate cortex pertinent to pain and suppression.
• Discuss basic science research that links area’s 32, 24 and 25 with pain and its relief.
• Apply specific techniques to modulate cortical areas 32, 24, and 25 for pain suppression.
• Formulate and implement a treatment plan based on the M1-ACC pain model.

• Explain the complex multidimensional and individual specific nature of pain
• Present the theories and science for understanding pain
• Define the terminology for describing pain and associated conditions
• Describe the impact of pain on society
• Explain how cultural, institutional, societal and regulatory influences affect assessment and management of pain  
• Use valid and reliable tools for measuring pain and associated symptoms to assess and reassess outcomes as appropriate for the clinical context and population.
• Describe patient, provider, and system factors that can facilitate or interfere with effective pain assessment and management
• Assess patient preferences and values to determine pain-related goals and priorities
• Demonstrate empathetic and compassionate communication during pain assessment

• Explain the complex multidimensional and individual specific nature of pain
• Present the theories and science for understanding pain
• Define the terminology for describing pain and associated conditions
• Describe the impact of pain on society
• Explain how cultural, institutional, societal and regulatory influences affect assessment and management of pain  
• Use valid and reliable tools for measuring pain and associated symptoms to assess and reassess outcomes as appropriate for the clinical context and population.
• Describe patient, provider, and system factors that can facilitate or interfere with effective pain assessment and management
• Assess patient preferences and values to determine pain-related goals and priorities
• Demonstrate empathetic and compassionate communication during pain assessment
• Demonstrate the inclusion of patient and others, in the education and shared decision-making process for pain care
• Identify treatment options that can be assessed in a comprehensive pain management plan
• Explain how health promotion and self-management strategies are important to the management of pain
• Develop a pain treatment plan based on benefits and risks of available treatments
• Monitor the effects of pain management approaches to adjust the plan of care as needed
• Differentiate physical dependence, substance use disorder, misuse, tolerance, addiction, and nonadherence
• Develop a treatment plan that accounts for the differences between acute pain, acute-on-chronic pain, chronic/persistent pain, and pain at end of life
• Describe the unique pain assessment and management needs of special populations
• Explain how to assess and manage pain across settings and transitions of care
• Describe the role, scope of practice, and contribution of the different professions within a pain management care team
• Implement an individualized pain management plan that integrates the perspectives of patients, their social support systems, and health care providers in the context of available resources
• Describe the role of the clinician as an advocate in assisting patients to meet treatment goals

• Demonstrate the inclusion of patient and others, in the education and shared decision-making process for pain care
• Identify treatment options that can be assessed in a comprehensive pain management plan
• Explain how health promotion and self-management strategies are important to the management of pain
• Develop a pain treatment plan based on benefits and risks of available treatments
• Monitor the effects of pain management approaches to adjust the plan of care as needed
• Differentiate physical dependence, substance use disorder, misuse, tolerance, addiction, and nonadherence
• Develop a treatment plan that accounts for the differences between acute pain, acute-on-chronic pain, chronic/persistent pain, and pain at end of life
• Describe the unique pain assessment and management needs of special populations
• Explain how to assess and manage pain across settings and transitions of care
• Describe the role, scope of practice, and contribution of the different professions within a pain management care team
• Implement an individualized pain management plan that integrates the perspectives of patients, their social support systems, and health care providers in the context of available resources
• Describe the role of the clinician as an advocate in assisting patients to meet treatment goals

• Determine why communication is imperative in clinical encounters
• Classify rights and responsibilities of the patient -provider partnership
• Recognize barriers and benefits regarding improved communication
• Apply numerous strategies to improve and solidify patient interactions
• Summarize how to fix the system so providers will provide better quality visits

• Identify the ways your conscious or unconscious bias toward patient characteristics may enter the clinical relationship
• Outline ways to improve your clinical communication with patients who are elderly, poor or ethnic minorities.
• Distinguish male and female patient communication styles and plan what to do when your patient wants a different gender provider
• Compare the way Jewish, Irish, Italian, and other cultures present differently as patients and prepare your communication style appropriately
• Internalize the seven ideal interpersonal traits patients want in their health care providers

• Recognize deceptive behaviors from other people and integrate these skills
• Use tips garnered from former CIA officers to separate truth from lies
• Determine motivations for patients to lie to health care providers
• Strategize ways to avoid being lied to by your patients and staff
• Assess the consequences of lying and how it compromises clinical relationships

• Explain the Four Habits of Highly Effective Clinicians
• Show the payoffs for each of the habits and provide examples
• Demonstrate how to avoid “Door Knob Concerns” and uncover hidden problems
• Specify barriers to patient communication and how to overcome them
• Describe action steps to incorporate better communication habits into practice immediately

• Modify explanations about risks, harms and benefits to avoid miscommunication to patients
• Apply research concepts such as sensitivity and specificity to outcomes communications
• Identify weak spots in clinical trials with regard to benefits and harms
• Implement the best practitioner action to build trust in patients
• Discover strategies for better communicating with low functional health literacy patients

• Describe and utilize an effective but non-invasive treatment for warts
• Understand the risk versus benefit of diagnostic imaging radiation in children
• Recognize patterns of pain in children that might actually indicate malignancies
• Develop an understanding of pediatric atlantooccipital dislocation
• Be able to perform 5 minute infant physical examination to detect congenital anomalies of the musculoskeletal system

• Determine the epidemiology of low back pain in children and adolescents
• Assess the risk factors associated with back pain in school children
• Outline the effect of an intervention to improve sitting habits in schoolchildren
• Assess the effects of reading a book or using a computer on neck and upper back muscle activity in children

Hour 1

• Discover what primitive reflexes are and why we have them
• Understand the various possible causes of retained primitive reflexes in a child
• Outline common questions that would suggest retention of primitive reflexes
• Identify and assess eight primitive reflexes that can be easily evaluated by a doctor of chiropractic, specifically the Moro, Grasp, Spinal Galant, Rooting, Asymmetrical Tonic Neck, Symmetrical Tonic Neck, Tonic Labyrinthine, and the Landau reflexes.

Hour 2

• Further identify and assess the remaining of the eight primitive reflexes not covered in the first hour
• Detect the presence or absence of specific primitive reflexes
• Recognize the need for intervention when a retained primitive reflex is demonstrated by a patient
• Prescribe a specific course of treatment for each of the eight primitive reflexes if they are determined to be retained

• This contains all courses with the educational objectives listed from Pediatrics 116 through Pediatrics 119

Hour 1:

• Learn age-appropriate general health screening and health education for babies.
• Analyze through evidence the use of chiropractic manipulation for pregnant women.
• Identify normal growth, development and behavior and their assessment, as well as approaches to abnormalities for neonatals.
• Describe a typical pediatric examination on a neonatal.

Hour 2:

• Learn age-appropriate general health screening and health education for toddlers.
• Analyze through evidence the use of chiropractic manipulation for toddlers through young children.
• Identify normal growth, development and behavior and their assessment, as well as approaches to abnormalities from infancy through toddlers.
• Describe a typical pediatric examination on an infant 1-5 years old.

Hour 3:

• Learn age-appropriate general health screening and health education for adolescents.
• Identify the signs and symptoms of mild traumatic brain injury (through accident and sport) in children.
• Discuss and describe typical examination forms and outcome assessment tools used for the pediatric population.
• Evaluate through clinical cases and it’s management.

Hour 1

• Explain the necessity of evidence for infant healthcare
• Describe what mothers want from healthcare for their newborn?
• Outline the need for and development of the United Kingdom Infant Questionnaire
• Cite the outcomes of infant care in chiropractic practice and the adaptability of a parent-reported outcome measure to the infant population

Hour 1 

• Describe recommended health guidance for infants.
• Analyze evidence-based research with regards to the efficacy of spinal mobilization and soft tissue treatment in the infant.
• Develop a treatment plan in how to teach parents how to anticipate safety needs and promote healthy musculoskeletal practices for their babies.

 Hour 2

• Discuss important developmental changes that mark the transition from infancy to early childhood.
• Describe recommended health guidance for toddlers.
• Analyze the data surrounding chiropractic care for the toddler child, with a focus on spinal manipulation.
• Identify safety precautions that can be implemented in and outside of the office for toddlers.

Hour 3

• Discuss the developmental changes that mark the transition from the toddler to school-aged child.
• Describe recommended health guidance for preschoolers.
• Analyze the data surrounding chiropractic care for the school aged child, with a focus on spinal manipulation.
• Discuss the motor, verbal and neurological findings of developmental milestones in children.

• Compare the effectiveness of chiropractic spinal manipulation versus sham manipulation in children aged 7-14 with recurrent headaches.
• Outline current evidence on the functional changes associated with neck pain in adolescents.
• Investigate the role of chronic physical illness, mental health disorders and psychological conditions as potential triggers or risk factors for low back pain in children, adolescents, and young adults.
• Estimate whether carrying a heavier schoolbag (> 10% of bodyweight) is associated with a higher prevalence of low back pain in children between the ages 9 and 16.
• Examine the changes that are occurring in young athlete’s development and implications on movement, performance, and injury.

• Identify examples of traumatic spine, soft tissue and other commonly missed injuries
• Develop a post-traumatic diagnostic imaging algorithm and protocol 
  
• Recognize and develop an awareness for PI patient, carrier and attorney risks and liabilities
• Discuss several areas of PI documentation scrutiny including the causation statement

• Identify examples of traumatic spine, soft tissue and other commonly missed injuries
• Develop a post-traumatic diagnostic imaging algorithm and protocol 
  
• Recognize and develop an awareness for PI patient, carrier and attorney risks and liabilities
• Discuss several areas of PI documentation scrutiny including the causation statement

• This contains all courses with the educational objectives listed from Personal Injury 201 - 204

Hour 1 - PI Case Management Part 1

• Identify and avoid common PI history mistakes and liabilities
• Recognize many keys to a quality initial PI patient history
• Develop an awareness for the materials and tools necessary for a PI history
• Create a plan and protocol to improve the quality and thoroughness of the PI history

Hour 2 - PI Case Management Part 2

• Recognize common PI history red flags and contraindications 
• Identify symptoms and clinical history for two common PI traumatic injuries 
• Create a plan to identify and eliminate common patient errors pertaining to the PI history
• Develop an awareness for potential med-legal issues that can arise from a PI history

Hour 3 - How to Humanize Your PI Cases

• Create a protocol to consistently implement outcome assessments into PI cases 
• Recognize other options and opportunities available to humanize PI cases   
• Identify common outcome assessments utilized in PI cases
• Improve awareness of clinical decisions that can be made from humanizing cases

Hour 1 - Your Personal Injury History: Part 1

• Identify and avoid common PI history mistakes and liabilities
• Recognize many “keys’ to a quality initial PI patient history
• Develop an awareness for the materials and tools necessary for a PI history
• Create a plan and protocol to improve the quality and thoroughness of the PI history

Hour 2 - Your Personal Injury History: Part 2

• Recognize common PI history “red flags” and contraindications
• Identify symptoms and clinical history for two common PI traumatic brain injuries 
• Create a plan to identify and eliminate common patient errors pertaining to the PI history
• Develop an awareness for potential med-legal issues that can arise from a PI history

Hour 3 - Your Personal Injury Examination – Part 1

• Recognize the key elements of the Personal Injury post-traumatic examination
• Identify clinical contraindications and precautions prior to an examination
• Develop and map out a post-traumatic cervical spine examination protocol
• Identify and examine common motor vehicle crash shoulder conditions

Hour 4 - Your Personal Injury Examination – Part 2

• Discuss the critical components of a Personal Injury neurological examination
• Develop a traumatic brain injury examination screening protocol
• Recognize the documentation elements necessary in a PI physical examination
• Create a protocol for medical consultations, diagnostic imaging and testing

• Recognize the importance diagnostic imaging and testing in Personal Injury and trauma
• Summarize several of the common diagnostic imaging and testing available  
• Justify medical necessity and clinical rationale for imaging/testing in the treatment records
• Determine both a protocol and clinical necessity for plain film radiographs

• Recognize elements of Personal Injury case management
• Identify common inherent risk within PI case management    
• Summarize several insurance carriers concerns regarding PI case management   
• Discuss current PI case management issues in the med-legal arena

• This contains all courses with the educational objectives listed from Personal Injury 205 through Personal Injury 212

• Discover the importance of identifying case management issues early   
• Summarize emergency, urgent care and early intervention management  
• Recognize med-legal issues in the early providers management  
• Outline the application of home and self-care as part of case management

• Recognize the importance of Personal Injury physical examination
• Outline the examination of common traumatic injuries and conditions       
• Summarize common examination tests and procedures associated with a PI examination    
• Demonstrate support for care and management with examination documentation

• Outline the preparation for traumatic injury care and case management 
• Summarize the application of passive and active modalities in traumatic injuries
• Develop a protocol for implementing active therapeutic procedures and clinical exercise       
• Identify common therapeutic and conservative care risks and mistakes

• Recognize the importance of diagnostic imaging in Personal Injury
• Summarize specific diagnostic imaging tests for common PI injuries  
• Identify several common clinical indicators for PI diagnostic imaging
• Develop a protocol for ordering and monitoring PI diagnostic imaging         

• Recognize the importance of humanizing traumatic patient injuries
• Demonstrate the general application of assessments and PI interrogatories
• Summarize the importance, applications and protocols of medical photography
• Interpret assessments and PI interrogatories for case management decisions

• Recognize the importance of Personal Injury co-management
• Design a process for finding providers for co-management consults and referrals
• Develop protocols for co-management with primary care providers
• Devise a plan to begin, apply and implement PI case management clinical decisions

• Determine options for co-management with pain management providers
• Identify co-management opportunities with orthopedic and neurology providers
• Develop documentation protocols to support co-management decisions
• Summarize and implement Personal Injury case management protocols and procedures

• Recognize the importance the 5 steps represent in PI cases      
• Develop a plan to identify common PI acute injuries and conditions
• Design an in-office process to improve consistency of documentation
• Identify and evaluate several acute injuries and conditions

• Estimate the risk for an association between exposure to neck pain from a motor vehicle accident and future neck pain
• Estimate the risk for an association between exposure to neck pain from a motor vehicle accident and future back pain
• Appraise the validity of employing a biomechanical approach to assess injury risk from minimal damage traffic crashes
• Assess which factors predict the risk of developing post-traumatic headache six months following a motor vehicle collision (MVC) in adult

• Construct examination/radiographic criteria for Osteochondritis Dissecans
• Dissect the elbow as it relates to lateral epicondylitis
• Develop a diagnostic and treatment approach for adhesive capsulitis
• Review possible causes of Intervertebral Disc Degeneration
• Create a list of differential diagnoses of foot pain

• Develop an understanding of shoulder anatomy and motion as they pertain to diagnosis and treatment of the injured shoulder
• Review examination techniques relative to diagnosis of injury in the overhead athlete
• Review the characteristics and diagnosis of shoulder injuries common to overhead athletes
• Understand the functional anatomy of joint and the classification of traumatic injuries of the acromioclavicular joint
• Develop understanding of the mechanisms, examination, diagnosis, radiography and treatment of common acromioclavicular joint injuries

• Identify common causes of patellofemoral syndrome
• Understand knee mechanics relative to patellofemoral syndrome
• Differentially diagnose patellofemoral syndrome from other knee conditions
• Define an appropriate treatment program for patellofemoral syndrome

• Identify common causes of shoulder syndrome
• Understand functional mechanics of the shoulder relative to impingement syndrome
• Differentially diagnose shoulder impingement from other shoulder conditions
• Define an appropriate treatment program for impingement syndrome.

• Identify common risk factors and causes for CTS
• Define tests and examination procedures to diagnose CTS
• List the common conditions important in the differential diagnosis of CTS
• Develop a chiropractic treatment plan for CTS

• Understand the use of plain film and advanced imaging for patients with Rheumatoid Arthritis
• Identify conservative treatments for Rheumatoid Arthritis
• Discuss supplements relative to alleviating Rheumatoid Arthritis symptoms as well as other treatment additions to the patient's drug regimen
• Provide an overview of the rheumatoid arthritis diagnosis and traditional treatments

• Understand the general features of congestive heart failure, a condition which currently affects 4.9 million Americans
• Determine physical examination and diagnostic imaging findings in patients with congestive heart failure
• Discuss treatment, including conservative management, for congestive heart failure patients
• Discuss conditions commonly associated with congestive heart failure

• Define the classifications of Breast cancer and compare the stage
• List some of the major risk factors for Breast Cancer
• List some of the screening techniques for the detection of Breast Cancer
• Discuss some main options in evaluating breast cancer
• List some of the treatment options that are available for women with a genetic predisposition for Breast Cancer

• List some of the risk factors for low back injuries in the work place
• List the classes of low back etiologies and describe some of the spinal diseases that may cause low back syndrome exacerbation
• List some of the protocols for documenting and managing repetitive stress type injuries and low back pain and describe some of the factors to consider when documenting
• List some of the clinical manifestations of pain
• Describe some of the orthopedic tests that may be utilized in the examination for low back pain
• List some treatment options for Low back injuries

• Relate relatively common but sometimes challenging patient cases
• Explain diagnostic and therapeutic considerations in thyroid disease
• Give examples of diagnostic and therapeutic considerations in drug toxicity
• Describe diagnostic and therapeutic considerations in diabetic neuropathy
• Demonstrate diagnostic and therapeutic considerations in vitamin deficiency

• Summarize premenstrual syndrome, its diagnosis, causes and natural therapies
• Understand premenstrual dysphoric disorder, its diagnosis, causes and natural therapies
• Outline polycystic ovarian syndrome, its diagnosis, causes and natural therapies
• Illustrate menopause, its diagnosis, causes and natural therapies
• Discuss nutritional support for womens health

• Differentiate between premenstrual disorder, menopause and perimenopause
• Identify the causes of Estrogen Dominance in the typical patient for patient education
• Assess hormone levels and diagnosis with saliva and blood spot testing with reputable labs listed
• Observe recorded changes in actual patient histories with treatments and results
• Apply products listed by Brand Names to use for treatments, with suggested dosages

• Diagnose Fibromyalgia and Discuss the modern research that contradicts older ideas about the syndrome, separating myth from fact
• Obtain an accurate diagnosis and differentiate from other syndromes
• Recognize prescription medication side effects
• Apply appropriate movement and exercise therapy
• Select the best alternative and holistic treatments and design a treatment plan
• Treat using integrated care, including physical, emotional and spiritual support as needed

• Detect Intracellular inflammation and its effects on the entire body
• Define Oxidation and illustrate the importance of quality anti-oxidants
• Discover affordable tests you can easily run in your office to determine levels of oxidative stress
• Recall what causes free radicals and discover what resolves the problem
• Summarize environmental toxins and their realistic effects on the health of your patients, your family and you
• Show that Insulin resistance is yesterday’s news, now it’s Hormonal resistance Analyze weight loss resistance and how to correct it
• Analyze lifestyle choices that "pull the trigger" for epigenetics and how to reverse it
• Describe the new catch-all term: Mitochondrial diseases. Formerly known as “no known cause, no known cure”
• Summarize Methylation, Methyl donors, and its depletion
• Examine cell membrane impermeability and its effect on your paradigm of health
• Determine the role of antioxidants, fatty acids, and vitamin D: what you should use in your clinic now to get people well

• Utilize Salivary pH readings to determine the need for Fatty Acid Supplementation and dietary modification
• Discuss Candidiasis with your patient and interpret the results of their home self-test
• Determine if your patient is best served with a vegetarian lifestyle, and if not, measures you can take to improve their health
• Interpret the Zinc Tally test for your patient and prescribe a treatment plan that can greatly improve the overall health and longevity of your patient
• Measure specific blood pressure readings to demonstrate adrenal hypofunction
• Formulate your treatment plan based upon your results Discover an affordable and simple test for Sick Building Syndrome, Toxic Mold and other toxic loads
• Rate a patient’s need for calcium and mineral supplementation with the easily-performed Tissue Calcium Test
• Identify important underlying factors in weight loss or gain with Barne’s Thyroid Test
• Diagnosis an underlying deficiency that contributes to immune dysfunction, metabolic dysfunction, weight gain, skin rashes and more
• Quickly determine a definitive need for hydrochloric acid supplementation in every patient with gastric upset

• Define Genetic Testing and name some of the components in the gene that are being examined.
• List some laboratory techniques used in genetic testing.
• Name some types of genetic tests and explain the purpose of the tests. 
• Describe some of the methods of obtaining gene samples for laboratory analysis
• List some of the limitations and risks for genetic testing
• Discuss some of the ethical issues in genetic testing

• Define Fibromyalgia from an allopathic perspective
• Review historical treatment by traditional medical community
• Examine current allopathic theories and treatments
• Review signs and symptoms, demographics and presentation of the fibromyalgia patient
• Obtain an accurate diagnosis through labwork and history as it pertains to the fibromyalgia patient.
• Differentially Diagnosis adrenal fatigue, perimenopause, myofascial pain syndrome, chronic fatigue
• Determine the Labwork needed to evaluate a fibromyalgia patient
• Discuss the fibromyalgia patient’s point of view of symptoms and treatments
• Contrast the varying possible diagnoses from the alternative healer viewpoint
• Explain the Fibromyalgia “personality type”
• Create a team approach with other practitioners in the treatment of the fibromyalgia patient
• Determine the appropriate organic treatments that may be needed to treat the fibromyalgia patient including Gluten intolerance, Food allergies, and Supplementation
• Discuss Musculoskeletal treatments for fibromyalgia patients including Adjustments, Massage, and Prolo therapy
• Integrate appropriate exercise and home remedies for the fibromyalgia patient including 5 Tibetan Rites, Yoga, Walking, and swimming

• Describe reasons for including neurotransmitter evaluation in a clinical practice
• Recognize that common symptom patterns that can occur from neurotransmitter imbalance
• Defend the use of urinary neurotransmitter evaluation as valid biomarkers
• Document reasons for neurotransmitter depletion
• Summarize methods of neuropharmacology intervention
• Select the appropriate test for symptom pattern Interpret neurotransmitter patterns from test results

• Discuss the effects of spinal manipulation on headache
• Refer for alternative remedies for headaches
• Evaluate the emotional and mind-body connections as it relates to headaches
• List 14 different categories of foods that can trigger a Migraine
• Discover the eastern diagnosis of underlying conditions for headaches, including emotional and spiritual blockages
• Create a treatment plan for addressing the headache and potential underlying conditions
• Differentially diagnose underlying conditions related to headache
• Educate your patients on home remedies for their headaches
• Examine the economic impact of headaches
• Discriminate between headache pains and locations
• Recognize migraine headaches, even when head pain is not present
• Specify musculoskeletal treatments to reduce or eliminate headache symptoms

• Recognize the signs and symptoms of a low back disorder
• List the differential diagnosis of low back disorders
• Outline the different elements of a low back examination
• Identify “red flags” in the examination and evaluation of low back patients
• Summarize additional low back tests that can be performed and the reasons why to use them

• Compare knee joint biomechanics during running and cutting tasks performed with and without ankle taping
• Review common and unusual causes of lateral ankle pain
• Examine the effects of foot orthotics on overpronation and gait
• Relate the current state of knowledge about the pathogenesis of hallux valgus
• Apply contemporary knowledge to the assessment, management and prevention of ankle sprains
• Appraise the relationship between posterior lower limb muscle tightness and plantar fasciitis

• This contains all courses with the educational objectives listed from Physical Diagnosis 146 through Physical Diagnosis 159

• Recognize the signs and symptoms of an elbow disorder
• List appropriate exam procedures for differential diagnosis of elbow disorders
• Outline the different elements of a elbow exam
• Discuss the importance of “red flags” in the exam and evaluation of elbow complaints
• Summarize additional elbow tests that can be performed and under what conditions to use them

• Identify and describe the signs and symptoms hip disorders
• Synthesize differential diagnosis of hip disorders
• Outline and analyze the different elements of a hip exam
• Comprehend the nature of spinal cord and cauda equina injuries and determine their importance in hip disorders
• Apply knowledge of available hip assessments and evaluate how each can best be utilized

Hour 1

• Identify and describe the signs and symptoms hip disorders
• Synthesize differential diagnosis of hip disorders
• Outline and analyze the different elements of a hip exam
• Comprehend the nature of spinal cord and cauda equina injuries and determine their importance in hip disorders
• Apply knowledge of available hip assessments and evaluate how each can best be utilized

Hour 2

• Recognize the signs and symptoms of a neck disorder
• Differentially diagnose neck disorders
• Perform the different elements of a neck exam
• Comprehend the importance of "red flags" in the exam and evaluation of neck complainants
• Summarize additional neck tests that can be performed and under what conditions to use them

Hour 3

• Recognize the signs and symptoms of a shoulder disorder
• Be able to list differential diagnosis of shoulder disorders
• Outline the different elements of a shoulder exam
• Understand the importance of “red flags” in the exam and evaluation of shoulder complainants
• Be able to summarize additional shoulder tests that can be performed and under what conditions to use them

Hour 4

• Identify important chest and thorax landmarks in order to perform a lung examination.
• Summarize the various musculature associated with adult breathing mechanics.
• Demonstrate the differences between consolidation and effusion lung pathologies.
• Diagnose common adult lung pathologies with use of a medical history and full physical examination.

• Recognize the signs and symptoms of a neck disorder
• Differentially diagnose neck disorders
• Perform the different elements of a neck exam
• Comprehend the importance of "red flags" in the exam and evaluation of neck complainants
• Summarize additional neck tests that can be performed and under what conditions to use them

• Recognize the signs and symptoms of a shoulder disorder
• Be able to list differential diagnosis of shoulder disorders
• Outline the different elements of a shoulder exam
• Understand the importance of “red flags” in the exam and evaluation of shoulder complainants
• Be able to summarize additional shoulder tests that can be performed and under what conditions to use them

• Identify important chest and thorax landmarks in order to perform a lung examination.
• Summarize the various musculature associated with adult breathing mechanics.
• Demonstrate the differences between consolidation and effusion lung pathologies.
• Diagnose common adult lung pathologies with use of a medical history and full physical examination.

• Define the differences between visual fields and pathways.
• Recognize the three most common eye conditions and diseases affecting the cranial nerves seen within the chiropractic practice.
• Diagnose common eye diseases and conditions from a funduscopic examination.
• Propose management and co-management options for specific common eye conditions.

• Explain jurisdictional authority over school enrollment and pre-participation physical examinations
• List the common items required on a school enrollment and pre-participation physical examinations
• Outline the key components of the health history
• Identify normal values for vision and hearing acuity
• Calculate BMI and determine age appropriate percentile ranking
• Classify physical maturity using the Tanner Scale
• Assess immunization records for statutory compliance
• Indicate the difference in the level of detail required in the pre-participation exam versus the school enrollment physical
• Recognize the classifications of sports based on exertion required and level of contact
• Describe the process of clearing an athlete to resume training and competition
• Recognize the risk factors to sudden cardiac death syndrome
• Determine the association between risk factors and specific sports

• Recognize the elements and significance of the jugular venous pulse
• Know the physiology and sound of S1 and S2
• Know the physiology and sound of S3 and S4
• Identify systole and diastole by palpation and listening
• Describe heart murmurs
•  Hear and understand the mechanism of two common systolic murmurs

• Justify the addition of manipulative therapy to rehabilitation in the management of recurrent ankle sprain with functional instability
• Compare the effectiveness of plantar fascia-specific stretching to high-load strength training in patients with plantar fasciitis
• Examine the biomechanical mechanisms that may be involved in the foot-to-low back relationship, and how foot orthoses might be used to manage low back pain
• Outline the state of current clinical evidence regarding the use of manual therapies in the treatment of lateral ankle sprains
• Summarize relevant concepts for the diagnosis and management of ankle syndesmosis injuries

• Differentially diagnose prostate pathologies in individuals who present to your office with musculoskeletal pain,
• Differentiate various types of common prostate pathologies
• Expand understanding of prostate pathophysiology, including hormonal and biochemical implications
• Identify prostate pathology risk factors
• Identify the common pre-disposing factors for prostate pathologies that can ultimately mimic musculoskeletal complaints
• Interpret conventional prostate diagnostic procedures and identify protocols to evaluate and monitor prostate health and/or pathology
• Hone diagnostic skills by reviewing and analyzing patient case studies, inclusive of history, exam findings, lab test results for patients presenting with musculoskeletal complaints that may have underlying prostate pathologies

• Recognize the signs and symptoms of a wrist and hand disorder
• Be able to list appropriate exam procedures for a differential diagnosis of wrist and hand disorders
• Outline the different elements of a wrist and hand exam
• Discuss the importance of “red flags” in the exam and evaluation of wrist and hand complaints
• Be able to summarize additional wrist and hand tests that can be performed and under what conditions to use them

• Outline the current state of the literature on the etiology, diagnosis and management of frozen shoulder
• Clarify the influence of the spine on shoulder range of motion in middle-aged and elderly patients
• Assess the utility of three clinical tests evaluating subscapularis muscle function
• Utilize and integrate a simple clinical test to assist in distinguishing neck from shoulder pain
• Summarize the recent Clinical Practice Guideline (APTA) regarding the treatment of adhesive capsulitis

• Recognize the signs and symptoms of a mid-back disorder
• Be able to list differential diagnosis of mid-back disorders
• Outline the different elements of a mid-back exam
• Understand the importance of “red flags” in the exam and evaluation of mid-back complainants
• Be able to summarize additional mid-back tests that can be performed and the reasons why to use them

• Understand basic genetic and how this new field of medicine may impact your practice
• Learn and key common genomic medicine study type.
• Critically evaluate genomic medicine studies by identifying bias, evaluating effect size, and applying it to your patient.
• Understand the cardiovascular disease association between the SNPs ApoE, Kif6, and MTHFR.
• Consider how polymorphisms may impact the placebo effect.

• List five statistical references that relate to evidence based practice.
• List four Red flags that are pertinent in the evaluation component of treatment.
• Identify the five categories that pertain to possible spinal pain and referred pain.
• Describe two metabolic diseases that can affect the spine.

• This contains all courses with the educational objectives listed from Physical Diagnosis 166 through Physical Diagnosis 169

• Recognize and list four red flags for the cervical and shoulder girdle.
• Identify three medical conditions that may refer to the cervical spine but are non-musculoskeletal in origin and require a physician's intervention.
• Name and describe two CPR for the Cervical Spine.
• List two dural tests that are done for the nervous system in the Cervical region.

• Identify and describe two musculoskeletal issues of the thoracic region.
• List one dural test that is used to evaluate the thoracic region which will assist in determining normal neuromeningeal pathway mobility.
• List two CPR of the spine in the thoracic region that have good reliability and are effective in use.
• List and describe two vascular diagnoses which may relate to Thoracic Spine referred pain

• Identify two serious pathologies that appear to be related to the lumbar spine but are not.
• Describe three categories of pelvic fractures than may occur.
• Describe the objective differences between vascular claudication and neurogenic claudication.
• List the five screening tests for the pelvis and SI joint.

Hour 1:

• Knowledge of human gait analysis and its application to clinical scenarios.
• Explain the common gait terminology, such as stride length, step width, and cadence.
• Identify the stance and swing cycles of gait.
• Summarize the gait cycle and how it relates to normal human ambulation.
• Explain how movements at the pelvis, lower extremity, hip, knee, ankle, and subtalar joints interact during stance to conserve energy, and to protect one from injuries that might otherwise result from the repetitive stresses that occur during gait.

• Describe how patients with over-pronation and over-supination present in a clinical setting.
• Comprehend the functional biomechanics of the lunge, and squat and its relationships to faulty movement patterns.
• Compare Janda’s lower extremity functional screens.
• Demonstrate that clinical gait analysis alters treatment decisions to improve functional outcomes.

Hour 3:

• Illustrate the LEFS (lower extremity functional scale), and report its clinical value.
• Demonstrate evidence-based exercises to help improve over-pronation in patients.
• Apply the scientific foundations of modifications for custom orthotics with clinical case scenarios.
• Illustrate, through the use of case scenarios the typical examination findings and documentation of gait analysis in the “O” (objective) section of notes.

• Identify musculoskeletal anatomy pertinent to the abdominal exam.
• Identify the location of intra-abdominal contents relative to the abdominal wall and what is normally palpable.
• Recognize examination techniques used for inspection, auscultation, percussion and palpation of the abdomen.
• Name advanced techniques used to evaluate the acute abdomen.

• Describe thyroid anatomy and physiology. 
• Outline the pathophysiology of hypothyroidism, including possible causes and associated conditions.
• Identify signs and symptoms of hypothyroidism and hyperthyroidism.
• Demonstrate the typical thyroid exam performed in the chiropractor’s office.
• Review the usual and customary conservative and non-conservation management for common thyroid conditions.
• Discuss the role of the chiropractic spinal manipulation in care for patients with thyroid conditions.

• Identify vascular anatomy pertinent to the cardiovascular exam
• Interpret cardiovascular physiology as it relates to physical examination.
• Discuss characteristics of, and techniques used to evaluate, the pulse and blood pressure.
• Name advanced techniques used to evaluate peripheral artery disorders and conditions.

• This contains all courses with the educational objectives listed in Physical Diagnosis 173 thru 175

Hour 1

• Define Nonspecific Low Back/Neck Pain            
• Outline the subcategories of Nonspecific Spinal Pain
• Provide an overview of different techniques
• Analyze the anatomical source of the injury
• Examine Differentiate the functional or anatomical diagnosis

 Hour 2

• Produce a specific conservative treatment plan
• Measure the patient’s response to care.
• Neurological differential diagnosis via pain patterns
• Choosing the most appropriate type of manual therapy
• Provide Appropriate Documentation

• Compare the difference between angular and linear motion.
• List the limiting factors necessary for stability in respect to linear motion.
• List and describe the function of the limiting structures of the atlantooccipital joint and the atlantoaxial joint.
• Describe the path of the vertebral artery from the subclavian artery to the basilar artery
• List the three types of Atlantooccipital fractures.
• Describe five diseases that may compromise the stability of the cervical region and how.
• List and elaborate on the immune specific diseases that can affect the atlantoaxial joint.
• Summarize the normal growth of the cervical spine and craniovertebral region in children.
• Outline the details of IFOMPT Framework for Red Flags.
• Demonstrate three stability tests of the cervical region and interpret the results.
• Demonstrate a neurological scan to clear spinal cord and neurological dysfunction in the cervical spine.
• Apply a vigorous mandatory scan for all patients to rule out serious pathology of the cervical spine and the neurological system and be able to interpret the results.

• Recognize the importance of knowing and diagnosing a tremor.
• Define what is a tremor List some of the general symptoms of a tremor.
• Discuss the triggers that may exacerbate a tremor.
• Name the main categories of a tremor.
• Recall the subclasses of action tremor List the most common diseases and syndromes demonstrating each type of tremor.
• Differentiate the symptoms of Essential tremors (ET) and debate the current gold standard treatment plan of action.

• Recognize and apply the diagnostic criteria for hypermobility spectrum disorders (HSD) including hypermobile Ehlers-Danlos Syndrome (hEDS).
• Outline the importance of blood pressure screening and review evidence-based recommendations for clinical practice.
• Appraise the evidence regarding nonpharmacological approaches used in the management of restless legs syndrome (RLS).
• Summarize a contemporary clinical framework for identifying red flags for four serious spinal pathologies that may present in chiropractic practice.
• Describe our contemporary understanding of the appropriate diagnosis and management of cervical spondylotic myelopathy (CSM).

• Investigate the effect of patient expectations on short-term, subjective improvement in recurrent or persistent low back pain patients.
• Determine whether the ritual of the history and physical examination results in meaningful change in pain and function for low back pain patients before any treatment is provided.
• Assess the potential negative effect of routine MRI reports on the perception of the patient and treatment outcomes and explore a method for improvement.
• Explore the level of association between kinesiophobia and pain, disability, and quality of life as well as its role as a prognostic factor in people with chronic musculoskeletal pain.
• Quantify the role of contextual effects in the nonpharmacologic treatment of knee osteoarthritis.

• Outline the congruence of the manual interventions used in clinical practice with the scientific evidence regarding the biomechanical aspects of degenerative disc disease (DDD) leading to pain.
• Compare the efficacy and cost-effectiveness of a stratified care model versus usual care for patients with sciatica.
• Assess the value of intervertebral disc degeneration detected in early adulthood as a predictor for progression of degenerative changes as well as low back pain symptoms and disability in middle age.
• Define deep gluteal syndrome and the deep gluteal space, as well as propose a general diagnostic pathway for this condition.
• Breakdown the utilization of conservative treatments used in lumbar disc herniation patients successfully treated nonoperatively versus unsuccessfully treated nonoperatively.

• Defend a contemporary view of the implications of the biology of pain and injury for sensorimotor function
• Outline neuroplastic structural and functional changes as they relate to non-specific (mechanical) low back pain and sensorimotor function
• Appraise the current state of the literature regarding the changes in motor control in those with low back pain
• Assess whether low back pain patients display signs of muscular guarding or splinting
• Summarize existing observational evidence regarding the association between primary or chronic headache and persistent low back pain

Hour 1 

• Document the patients history to include an accurate list of all herbal/dietary supplements and other medicinals they are taking and refer to their MD if there are any concerns that it will affect Chiropractic Care being considered
• Explain the concept of the use of simultaneous interventions to treat a single condition as it is relative to the patient history.

 Hour 2

• Discuss potential side effects of herbal/dietary supplement as components of history taking & physical exam procedures.
• Refer to Medical Doctor if you feel any signs or symptoms are related to any side effects of anything the patient is taking
• Give examples of how herbal/dietary supplement use may impact the history taking, physical exam procedures, and treatment plan.

Hour 3

• Describe pertinent patient medical history and physical examination procedures included in a comprehensive evaluation for conditions that may have been previously treated with surgical interventions
• Connect patient medical history and physical examination with evidence-based intervention/treatment plan of care to achieve best patient outcomes

Hour 4

• Identify evidence-based rehabilitation principles for patients whose history may include prior surgical intervention.
• Explain specific rehabilitation programs for each case based on documented evaluation findings

Hour 1

• Describe behavioral model for insomnia
• Explain why sleep quality is important
• Discuss sleep interventions as prevention for chronic musculoskeletal pain
• Discuss sleep interventions for chronic musculoskeletal pain

 Hour 2

• Ask the correct questions to assess sleep and sleep behaviors
• Identify factors to maladaptive sleep habits
• Discuss sleep efficiency and tracking progress
• Explain why rest in bed is not optimal
• Refer patients to appropriate healthcare providers for sleep dysfunction

• Increase awareness and recognition of statin intolerance in musculoskeletal patients.
• Learn the risk factors associated with Statin Associated Muscle Symptoms (SAMS).
• Identify the signs and symptoms of myositis/myopathy.
• Discuss the physiological process involved with SAMS and tests to confirm.

• Investigate the diagnostic accuracy of information from the patient history associated with hip-related pain 
• Characterize the association between manual therapy dosing and treatment outcomes for patients with hip osteoarthritis
• Summarize the literature regarding the diagnosis and non-operative treatment of femoroacetabular impingement (FAI) syndrome 
• Determine whether the addition of hip treatment and rehabilitation improves outcomes in patients with low back pain
• Quantify the prevalence of hip girdle weakness and tenderness in people with chronic non-specific low back pain

• List the major divisions and subcomponents of the neurological examination. 
• List, contrast and compare the neurological signs associated with “release phenomenon” and “deficit phenomena”.
• Contrast and compare the effects of neurological lesions on the neurological examination of the central nervous system versus the peripheral nervous system.
• Recite the implications of neurological examination findings on disorders involving various components of the central and peripheral nervous system.
• Draw the anatomy of the lower motor neuron in its relation to the spinal cord, nerve root, spinal nerve, and the neuro-myal junction.
• Describe the physical positioning of the patient during aspects of the neurological examination.
• List the subjects to question when in taking a good patient history.
• Describe and perform aspects of the neurological examination of the Cranial Nerves of the patient.
• Draw the neurologic pathways associated with the eye light reflexes.  Include reference to cells of the retina, the optic nerve, the optic chiasm, the optic tract, the Pretectal nucleus, and the Edinger Westphal nucleus.
• Describe and perform aspects of the neurological examination of the Motor Systems of the patient.
• Describe and perform aspects of the neurological examination of the Sensory Systems of the patient.
• Recite findings related to neurological “drift” performed during the neurological examination.
• Describe and perform aspects of the neurological examination of the Reflex Systems of the patient.
• Illustrate components of the muscle stretch reflex including the role of the Alpha motor neuron, Gama motor neuron, and large sensory fibers in relation to the muscle fibers and spinal cord.
• Discuss the common shorthand used for grading muscle stretch reflex responses and discuss the results of the neurological examination associated with each grade.
• Perform and discuss three versions of the extensor plantar response (extensor toe sign, Babinski sign).
• Describe and perform aspects of the neurological examination of movement of the patient.

• Discuss the use of electrotherapy to control pain
• Establish parameters for wobble board rehabilitation of the ankle
• Describe how SI manipulation affects anterior knee pain
• Discuss the use of post-fracture manipulation
• Construct therapeutic exercises for patients with lumbar spinal stenosis

• Describe ideal pad placement for interferential therapy
• Discuss increasing muscle strength in the elderly
• Construct screening procedures and treatment for the TMJ
• Relate the evaluation and treatment of whiplash
• Review rehabilitation of ankle injuries

• Explain that the key to increased utilization of ultrasound lies in chiropractic providers knowledge and training
• Recognize the ultrasound procedure, its benefits, effects, proper application, and potential outcomes
• Point out precautions and contraindications affiliated with ultrasound
• Internalize a level of knowledge and comprehension of diathermal principles
• Develop skill sets when rendering ultrasound (continuous or pulsed) therapy

• Discuss the unique properties of lasers and their clinical applications
• Identify indications and contraindications to cold laser therapy
• List parameters and protocols of cold laser therapy
• Evaluate the current body of low level laser therapy clinical research
• Explain the advantages and disadvantages of using cold laser therapy

• Define laser
• Discuss the critical properties of laser light and the categories of lasers
• Define power density and energy density
• Recognize the factors that effect the depth of penetration of light therapies
• Explain why certain frequencies are employed with therapeutic lasers
• Discuss the proposed physiological mechanisms of light therapy
• List the contraindications and precautions for the use of low level laser therapy
• Differentiate continuous wave and super pulsed laser therapy
• Describe the application techniques for low level laser therapy
• Describe light emitting diodes
• Describe ultraviolet radiation and the difference between UVA, UVB and UVC
• List the effects of UV light
• Describe the dosage determination method for UV therapy, MED and E1 - E3
• List the contraindications and precautions to the use of UV therapy

• Identify principles, indications and contraindications for ultrasound, heat, cold and electrical modalities with a focus on the upper extremity
• Utilize clinical guidelines for applying ultrasound, heat, cold and electrical modalities with a focus on the upper extremity
• Recognize and discuss the clinical efficacy and safety parameters of ultrasound, heat, cold and electrical modalities with a focus on the upper extremity

Hour 1

• Discuss the history of elastic taping.
• Define the anatomy of fascial layers in the human body, and how the mechanotransduction concept relates to the use of elastic taping.
• Recognize the most common indications and contraindications for the use of elastic tape within the manual therapist’s practice.
• Describe the application process of elastic taping .

Hour 2

• Discuss the evidence providing support of the use of elastic taping
• Outline various conservative management options for taping musculoskeletal problems
• Construct a treatment plan for a typical patient with acute traumatic swelling
• Apply specific taping techniques for certain biomechanical dysfunctions

Hour 3

• Describe and demonstrate the application of elastic taping procedures for carpal tunnel syndrome
• Describe and demonstrate the application of elastic taping procedures for biomechanical low back pain
• Describe and demonstrate the application of elastic taping procedures for shoulder stabilization
• Describe and demonstrate the application of elastic taping procedures for knee osteoarthritis

• Examine the relationship between hip flexibility and patellofemoral pain
• Summarize the evidence pertaining to the efficacy of manual and physical therapies for the management of Patellofemoral Pain Syndrome
• Outline the possibility of a continuum existing between patellofemoral pain and patellofemoral osteoarthritis
• Discuss the evidence regarding prevalence, diagnosis and management of patellar tendinopathy
• Review the most common clinical tests used to determine balance in those with knee OA a clinical setting

• Outline the innovation of the therapy
• Summarize the Physics behind the modality
• Describe the interaction of LLLT with live tissue
• Detect the contraindications & precautions
• Assess the different LLLT devices.
• Comprehend the different types of LLLT available
• Optimize the LLLT parameters for improved outcomes
• Apply LLLT in a manner that optimizes your treatment
• Explain the physiological effects to your patients
• Examine the current clinical evidence

• Appraise the combination of pain neuroscience education and exercise or motor control training to alter ‘pain memories’ associated with chronic pain
• Assess the relationship between vibration training and muscle strength and bone mineral density in older adults
• Measure the effects of whole-body vibration (WBV) training on balance and strength in elderly patients suffering from diabetic neuropathy who are at high risk of falls
• Examine the effectiveness of unimodal and multimodal physical therapies for base of thumb osteoarthritis
• Explore the evidence on the effects of manual therapy for the treatment of plantar heel pain

• Review sensory-motor control and rehabilitation
• Discuss aerobic exercise for LBP patients
• Describe muscle training of the hip, abdominal and paraspinal muscles
• Identify how aerobic exercise improves motor performance in the elderly
• Distinguish the effects of different training styles on the cross-sectional area of paraspinal muscles

• Describe the contribution of hip vs. spinal motion
• Distinguish poor motor patterns of hip and low back movements and what to do about it
• Differentiate the role of exercise for neck disorders and determine what type of exercise works
• Delineate the neural adaptations to exercise and apply towards rehabilitation
• Describe current issues in low back rehabilitation (such as can low back tissues heal within a few weeks)

• Describe the long term course of LBP
• Describe neuromuscular impairments following LBP
• Differentiate the effects of pain on the neuromuscular system
• Discuss the models that explain the nature of motor problems with pain
• Differentiate and discuss the potential sources of LBP

• Identify and describe the major factors influencing muscular strength
• Assess the chiropractic influences on strength
• Identify and discuss the strength training principles
• Illustrate components of a training session
• Apply training principles into a practical strength program

• Define proprioception and describe how it is measured
• Discuss proprioception from a rehabilitative perspective
• Examine ankle, knee and shoulder proprioception and rehabilitation
• Examine spinal proprioception and sensorimotor training
• Summarize rehabilitation recommendations for proprioceptive deficits

• Illustrate basic principles of cardiovascular exercise
• Discuss the mechanisms of cardiovascular responses to exercise
• Discuss the acute effects of exercise on the cardiovascular system
• Discuss the training effects of exercise on the cardiovascular system

• Summarize the functional anatomy of core strength training
• Discuss the principles of core strength
• Develop an assessment of spinal stabilization
• Distinguish specific evaluation tests for spinal stability

• Summarize the effect of training on the fatigue of multifidi muscles
• Discuss which muscles are involved in stabilization exercises
• Assess the relation between low back pain and clinical instability
• Describe a study implementing manipulation and stabilization exercises for chronic LBP
• Introduce the concept of functional restoration vs. physical therapy for LBP

• Describe the early health care utilization for occupational low back pain
• Determine which factors are important in predicting outcome after a spinal stabilization exercise program
• Assess lumbar disc surgery rates before and after implementation of nonsurgical spine clinics
• Determine whether kinematic compromise can be used to predict spine loading in low back pain (LBP) patients under realistic lifting efforts in a workplace
• Determine the effects of subacute LBP and limitation of the straight leg raise on lumbar and hip kinematics during sit-to-stand and its reverse

• Summarize the effect of whiplash on neck muscle strength
• Discuss the effects of manipulation vs. mobilization on head and neck pain in whiplash patients
• Assess the effects of thoracic manipulation in whiplash patients
• Describe a study predicting the response of neck pain patients to neck strengthening exercise
• Introduce the smooth pursuit neck torsion test and its application in whiplash disorders

• Identify the anatomy of upper motor neuron tract systems and discuss the functionality of upper motor neuron tract systems
• Explain the effects of a spinal cord injury
• Discuss the anatomy and functionality of regions of the brain
• Describe complications post injury of brain and spinal cord injury
• Describe standard treatment procedures prior to rehabilitation of brain and spinal cord injured patients
• Explain the difference between neurological deficit rigidity versus disuse atrophy/spasm of spinal cord and head injured patients
• Describe treatment options for rehabilitation of spinal cord and head injured patients
• Explain treatment methods to transition C curve locomotion to S curve locomotion
• Explain treatment methods for atrophy and spasm
• Discuss most current curative research for spinal cord and head injured patients

• Outline the anatomy of cervical spine proprioception
• Review clinical studies investigating cervical spine proprioception
• Assess existing literature on the reliability of cervical spine joint position sense
• Assess the effect of spinal adjustments/manipulation on cervical spine proprioception

• Summarize the central role of muscle protein in whole-body metabolism and muscle mass
• Outline the role of skeletal muscle metabolism in health and disease (such as diabetes, obesity, osteoporosis)
• Describe the role of hormones for influencing muscle metabolism and health
• Identify the catabolic and anabolic mediators of muscle metabolism
• Specify ways to maximize muscle mass and metabolism to promote wellness

• Explain the anatomical constituents of the core musculature
• Consider implications of weak or inadequate core muscles
• Emphasize the importance of the gluteal muscle group in rehabilitation
• Illustrate common compensation patterns when individuals have weak core musculature with clinical examples
• Explain the concept of neural adaptation
• Review reciprocal inhibition and it's clinical application
• Discuss physiological overflow and its clinical application

• Discuss conventional situps and their pitfalls
• Provide a logical rationale for core training
• Explain and demonstrate a logical progression of exercises for core training, emphasizing skill, then endurance and strength

• This contains all courses with the educational objectives listed from Rehab 115 through Rehab 125

• Recognize some of the common mistakes with conventional sit ups and how to correct them
• View and narrate the ideal sit up
• Recognize the importance of the brain and cortex in core training
• Discuss how inhalation and exhalation affect muscular activity, and how to utilize this in training
• Point out the pitfalls of abdominal hollowing and core training
• Examine the importance of the thoracolumbar fascia
• Analyze what cues to look for when evaluating a bench press exercise

• Demonstrate the proper patient positioning for the lunge and squat exercises
• Explain and show common problems with the lunge and squat exercises
• Explain and show Dr cues for proper patient positioning of the lunge and squat exercises
• Explain, evaluate, compare and demonstrate variations of the squat exercise, including ball squats, theraband squats, potty squats, squat shuffles
• Explore and demonstrate how foot function and shoe type impacts squat and lunge activities
• Introduce, explain and demonstrate proper and improper performance of additional, advanced gluteal activation exercises including the Texas walk, ball squats, drops, roman chair and 1 legged dead lifts

• Apply core exercise to facilitate improved lower limb mechanics in women
• Recognize the connection between improved lumbar multifidus function and clinical improvement after spinal manipulation
• Discuss the potential of full kinetic chain manual therapy treatment for hip osteoarthritis
• Assess muscle activation and spinal loading profiles during common Kettlebell exercises
• Describe specific exercises that could improve hip strength and mechanics in women with patellofemoral pain

• Describe the Nordic Hamstring exercise and its potential applications for hamstring injuries
• Summarize the state of the literature on exercise interventions for adolescent scoliosis
• Integrate strength training with flexibility training to improve patient progress
• Appraise the potential role of yoga in managing spinal conditions
• Grade and recognize the state of the literature on physical and rehabilitation interventions for chronic non-specific low back pain

• Compare slower treadmill walking on a moderate incline to faster walking with no incline for moderately obese adults patients
• Summarize the current state of the literature on exercise interventions for Type 2 Diabetes Mellitus
• Explain the utility of interval training for patients with coronary artery disease
• Support the inclusion of resistance training in exercise programs for aging patients based on existing scientific research
• Appraise various types of exercise for patients with metabolic syndrome

• Outline the neuroendocrine-immune interactions and communication pertaining to exercise
• Contrast sprint training with endurance training regarding performance adaptations and cardiac output
• Identify the benefits and underlying mechanisms of agonist-antagonist paired set training for improving strength and power
• Summarize the validity of dehydration signs, compared with body weight change, in marathon runners
• Describe methods for developing maximal neuromuscular power

• Apply contemporary rehabilitation strategies for anterior cruciate ligament patients
• Illustrate the importance of proximal stability and rehabilitation in patients with patellofemoral pain syndrome
• Outline the relationship between quadriceps strength, proprioception and knee osteoarthritis
• Discuss the potential value of gait retraining for improving lower limb biomechanics in runners with patellofemoral pain
• Contrast lower extremity kinematics & muscle activation in patients with and without patellofemoral pain syndrome

• Discuss a proposed model for the logical sequence of active rehabilitation
• Review ‘the core’, its healthy functional role and how it is commonly changed in people with spinal and pelvic girdle pain syndromes
• Describe core muscle activity during physical fitness exercises
• Provide an introduction to dynamic neuromuscular (core) stabilization and athletic performance
• Introduce the basics of exercise prescription

• Illustrate the effects of external pelvic compression on the passive, active and neuromotor control systems of the lumbopelvic region and thigh
• Summarize the importance of core stability assessment and rehabilitation in lumbosacral radiculopathy cases
• Assess the differences in torso motion and muscle activity between elliptical trainer use and treadmill walking
• Discover how even small amounts of daily exercise can positively impact patients with neck and shoulder pain
• Critique and apply periodization concepts to rehabilitation for patients with non-specific low back pain

• Outline the relationship between exercise and brain health
• Describe the evidence for the links between physical activity/exercise and brain function across the lifespan
• Discuss the neurobiology of exercise
• Assess whether exercise is neuroprotective or not
• Summarize the effect of exercise on motor performance

• Identify how the sciatic nerve and adjacent nervous structures respond to tensioning and sliding techniques
• Appraise the potential benefit of adding forward head posture corrective exercise to the management of lumbosacral radiculopathy
• Compare clinical and muscle function outcomes of patients randomized to one of two early multimodal rehabilitation programs following single-level lumbar discectomy
• Analyze the influence of neck strength and muscle activation status on resultant head kinematics after impulsive loading to the head/neck
• Assess the efficacy of corrective exercise interventions for reducing thoracic hyper-kyphosis

• Recognize and document preferred outcomes that result from properly executed active care techniques
• Establish rehab protocols for both cervical and lumbar conditions with suggested core exercise recommendations
• Properly advance a patient through their customized exercise protocol in a systematized fashion
• Identify and document progress on a routine visit basis for patients participating in active care rehab

• Evaluate the long-term effect of exercise therapy in addition to patient education on a patient’s need for total hip replacement (THR)
• Integrate clinical and laboratory research on the function and assessment of abductor muscles about the hip and pelvis 
• Understand how hip weakness can potentially contribute to knee pain and altered running mechanics
• Outline the nomenclature, definition, diagnosis, imaging and management of inguinal disruption (‘Sportsman’s Groin’) 
• Assess the efficacy of exercise interventions for lateral ankle sprains, Achilles tendinopathy and plantar fasciitis 

• Recite 3 risk factors for developing rotator cuff tendonosis
• State the purpose of the scapula reposition and scapula assistance test.
• Explain how to perform the external rotation lag sign and recall the purpose of this test
• Paraphrase one evidence - based test cluster for diagnosing a rotator cuff tear.
• Recall two indications/goals for performing posterior glenohumeral joint mobilizations.
• Cite the clinical prediction rule (CPR) for favorable outcome in patients undergoing conservative management for rotator cuff disorders
• Identify two criteria for phase I rehabilitation exercises for rotator cuff disorders

• Recall 3 potential reasons, based on expert opinion, that may contribute to the high re-tear rate following rotator cuff repair.
• Recite 4 factors that impact the rehabilitation program for patients following rotator cuff repair.
• Summarize the DeOrio classification for rotator cuff tear size.
• State 3 appropriate exercises during weeks 0-2 following rotator cuff repair
• Provide 2 appropriate exercises during weeks 6-8 following rotator cuff repair
• Name 3 appropriate exercises during weeks 8-12 following rotator cuff repair

Hour 1:

• Describe common biomechanically terminology related to rehabilitation such as work, force, mass, vector, strength and power.
• Comprehend the functional biomechanics of the lunge, and squat.
• Identify regressive and progressive nature to common squat and lunge exercises.
• Describe the appropriate standard of care and the process associated with the doctor-patient encounter regarding the evaluation, and management of patients using rehabilitative exercises.   

Hour 2:

• Classify the “McGill Big 3,” and discuss their clinical significance with those with spinal pain.
• Describe an appropriate hip hinge technique for your patients.
• Describe the differences between abdominal bracing and hallowing techniques.
• Review common evidence-based exercise procedures for spinal pain.

• Apply the scientific foundations of neuromuscular re-education, and explore major guidelines and evidence-based practices for spinal pain.
• Construct a treatment plan and exercise script for patient centered care.
• Describe a case scenario involved spinal degeneration and how to create a treatment plan.
• Synthesize the justification and efficacy of evidence-based exercises for different axial spine protocols.

• Enumerate three physical / clinical examination findings associated with rupture of the quadriceps tenon.
• List 3 patient specific factors that need to be considered when following a rehabilitation program following repair of the quadriceps or patella tendon.
• Recall three goals during phase 1 (0-2 weeks) of a rehabilitation program following repair of the quadriceps or patella tendon.
• Identify three goals during phase 3 of a rehabilitation program following repair of the quadriceps or patella tendon.
• Cite five return to play criteria that need to be met following repair of the quadriceps or patella tendon.

• Summarize the key difference between the cartilage restoration vs cartilage reparation procedures.
• List 3 personal (health and demographic) factors that need to be considered when following a rehabilitation program following cartilage restoration/reparative procedures.
• Enumerate 3 lesion-specific factors that need to be considered when following a rehabilitation program following cartilage restoration/reparative procedures.
• Recall three goals during phase 1 (0-2 weeks) of a rehabilitation program following cartilage restoration/reparative procedures.
• Cite five return to play criteria that need to be met following cartilage restoration/reparative procedures.
• Summarize the evidence-based outcomes for the 3 most common cartilage restoration/reparation techniques.

Hour 1

• Recall 2 pathological pitching mechanical patterns that may lead to injury
• List 3 injury risk factors in in the overhead athlete
• Provide 4 injury prevention screening tests for the overhead athlete
• With respect to shoulder strength, cite 3 metrics  that can be used as red flags to identify players who are at higher risk for incurring an injury to the shoulder /elbow

• Recall 2 pathological pitching mechanical patterns that may lead to injury
• List 3 injury risk factors in in the overhead athlete
• Provide 4 injury prevention screening tests for the overhead athlete
• With respect to shoulder strength, cite 3 metrics  that can be used as red flags to identify players who are at higher risk for incurring an injury to the shoulder /elbow
• Describe 1 clinical test to evaluate anterior and posterior shoulder instability
• List the 3 components of an evidence -based test cluster  to assess rotator cuff pathology in the overhead athlete
• Identify 2 components in the rehabilitation program for shoulder instability
• List and define the 3 types of shoulder impingement
• Recall 2 Performance factors in pitching
• Cite 2 return to play criteria for the overhead athlete
• Identify one advantage of weighted ball holds
• Identify one disadvantage of weighted ball programs

• Recall the most common types of lumbar spine injuries among athletes participating in different sports.
• Identify one advantage and one disadvantage of the treatment-based classification system as it applies to the treatment of the athlete’s lumbar spine.
• List 3 contemporary treatment models that can be applied to the management of lower back pain in the athlete.
• Recall the definition and importance of red and yellow flags during the medical screening process.
• Identify 3 red flags that may implicate a non-mechanical source of lower back pain.
• List the difference between central and peripheral sensitization.
• List one treatment goal in phase 2 rehabilitation of the athlete’s lumbar spine.
• Cite one treatment principle in phase 3 rehabilitation of the athlete’s lumbar spine.
• Summarize two variations of the squat exercises that can be used to decrease strain on the lumbar spine.
• Recall three variations of the deadlift exercises that can be used to decrease strain on the lumbar spine.
• Summarize the McGill core endurance ratio tests that can be used to guide the return to sport decision making processes

Hour 1

• Recall the most common types of lumbar spine injuries among athletes participating in different sports.
• Identify one advantage and one disadvantage of the treatment-based classification system as it applies to the treatment of the athlete’s lumbar spine.
• List 3 contemporary treatment models that can be applied to the management of lower back pain in the athlete.

Hour 2

• Recall the definition and importance of red and yellow flags during the medical screening process.
• Identify 3 red flags that may implicate a non-mechanical source of lower back pain.
• List the difference between central and peripheral sensitization.

Hour 3

• List one treatment goal in phase 2 rehabilitation of the athlete’s lumbar spine.
• Cite one treatment principle in phase 3 rehabilitation of the athlete’s lumbar spine.
• Summarize two variations of the squat exercises that can be used to decrease strain on the lumbar spine.
• Recall three variations of the deadlift exercises that can be used to decrease strain on the lumbar spine.
• Summarize the McGill core endurance ratio tests that can be used to guide the return to sport decision making processes

• Recall two important functions of the fascial system.
• Cite 3 factors which impact the mechanical properties of fascia.
• State one structural/ anatomical difference between the fascia of young vs. older individuals.
• List two ways that fascial training can cause remodeling of the fascia.

• Appraise the latest research in terms of the incidence of ACL tears and re-tears.
• Identify the factors associated with higher ACL tear and re-tear rates based on gender and age.
• Describe the importance of “Prehabilitation” programs and their significance on outcomes.
• Analyze the reasons why non-contact knee injuries are the bulk of the problem while listing the biomechanical reasons why non-contact injuries are more prevalent.
• Discuss the objectives of early Phase 1 and Phase 2  rehabilitation protocols while outlining the criteria to be achieved for satisfactory transition from one phase to the next 
• List the objectives of Phase 3 of the rehabilitation protocol and be able to identify potential common faulty movement patterns and compensatory strategies.
• Assess, identify, and address potential limitations in mobility and stability of key core and lower extremity body regions to normalize faulty movement patterns and compensatory strategies.
• List the objectives for phase 4 of the rehabilitation protocol and provide examples of the higher-level movement patterns and compound strengthening exercises incorporated into the program.
• Identify the four common motor performance/neuromuscular imbalances associated with jumping and landing resulting in increased risk
• Describe the identifiable and modifiable risk factors associated with knee injuries and understand how to correct them via exercise and training.
• Recognize the criteria associated with the Return to Sports phase of the rehabilitation program
• Be aware of the complications and adverse events after ACL reconstruction
• Appraise the latest research in terms of common and uncommon complications/adverse events.
• Identify risk factors for the various complications.
• Describe the evaluation and assessment elements needed to identify the various complications
• Based on the evaluation/assessment data, identify and address intervention strategies for each of the complications/adverse events

• Outline the evidence regarding rehabilitation interventions following anterior cruciate ligament (ACL) or meniscal injury
• Evaluate the effectiveness of rehabilitation interventions for patients who have undergone anterior cruciate ligament reconstruction surgery 
• Examine the comparative effectiveness of surgery versus rehabilitation treatments after an anterior cruciate ligament (ACL) rupture 
• Compare the effectiveness of exercise therapy with non-steroidal anti-inflammatories (NSAIDs) and opioids for the management of pain in patients with knee osteoarthritis 
• Determine the patellofemoral joint reaction forces during everyday activities, therapeutic exercises, and physical interventions in healthy individuals and those with patellofemoral pain or osteoarthritis

• Identify exercise physiology concepts related to core conditioning
• Determine the anatomy related to the core and its function in core strength
• Design and implement a core conditioning program
• Summarize the role of psychological motivation in core conditioning
• Examine the various movements associated with core conditioning

• Delineate the effects of spinal fixation on degeneration in relation to the chiropractic model of degeneration
• Determine the benefits of 3 common treatments thought to aid chronic spine pain including chiropractic
• Outline and categorize the neurophysiology of spinal manipulation
• Determine the effects of spinal manipulation and exercise on neck pain

• Discuss the epidemiologic evidence and debate about work-related musculoskeletal disorders
• Discuss the costs and financial burden associated with musculoskeletal disorders
• Discuss the factors involved in strain-induced injury of skeletal muscles
• Discuss the inflammatory process as related to musculoskeletal disorders

• Summarize the relation between neural plasticity, LBP and spinal manipulation
• Discuss the concept of intervertebral dysfunction with respect to paraspinal muscle
• Assess the correlation between back pain, disability and quality of life
• Describe a study implementing whole spine manipulation in primary care

• Summarize the dose-response relationship between chiropractic and LBP
• Discuss the differences between chiropractic adjustments and muscle relaxants for LBP
• Assess the relationship between osteopathic manipulation and prenatal outcomes
• Describe the association (or lack thereof) between spinal manipulation and lumbar disk herniations
• Analyze the results of a study on active care vs. manual therapy with active care

• Determine the effects of maintenance chiropractic care on chronic low back pain
• Delineate the demographic and clinic-related predictors for successful outcome of chiropractic patients with low back pain
• Compare individuals with and without chiropractic coverage
• Summarize the efficacy of medication, acupuncture, and spinal manipulation for chronic mechanical spinal pain syndromes
• Determine the effects of simulated spinal manipulation on facet joint strains

• Describe the principles of health behavior change
• Detail the factors that promote positive lifestyle changes
• Discuss current theories and models of behavior change
• Discuss techniques and processes of how to change health behavior

• Review articles addressing the latest information concerning chiropractic and/or spinal manipulation for neck pain and/or headaches
• Provide evidence-informed practice recommendations for the chiropractic treatment of headache in adults
• Determine the short-term effect of chiropractic joint manipulation therapy (CMT) and low-level laser therapy (LLLT) on pain and range of motion in the management of cervical facet dysfunction
• Assess whether adjusting dysfunctional cervical segments in people with subclinical neck pain can improve their upper limb joint position sense accuracy
• Investigate the efficacy of preventive spinal manipulative therapy (SMT) compared to a no treatment group in non-specific neck pain patients
• Assess the effectiveness of thoracic manipulation (TM) on patients with chronic neck pain
• Describe a randomized controlled trial comparing manipulation with mobilization for recent onset neck pain

• Review articles addressing the latest information concerning chiropractic and/or spinal manipulation of the lower back
• Assess the current scientific literature related to manipulation for acute low back pain
• Assess the current scientific literature related to manipulation for chronic low back pain
• Compare the clinical efficacy of spinal manipulation against microdiskectomy in patients with sciatica secondary to lumbar disk herniation (LDH)
• Review the Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) study
• Assess maintenance spinal manipulation therapy for chronic non-specific low back pain

• Review articles addressing the latest information concerning chiropractic and/or spinal manipulation for pregnancy related low back pain and/or post-partum pain
• Review the published evidence regarding chiropractic care, including spinal manipulation, for pregnancy-related low back pain (LBP)
• Describe the clinical outcomes of patients with pregnancy-related lumbopelvic pain (PRLP) treated according to a diagnosis-based clinical decision rule
• Assess osteopathic manipulative treatment of back pain and related symptoms during the third trimester of pregnancy
• Describe the development a clinical prediction rule (CPR) for identifying postpartum women with low back pain (LBP) and/or pelvic girdle pain (PGP) whose functional disability scores improve with a high-velocity thrust technique (HVTT)

• Discuss recent research on Chiropractic Manipulative Therapy for patients with 'Acute Low Back Pain'
• Discuss recent research on Spinal High-Velocity Low Amplitude Manipulation in Acute Nonspecific Low Back Pain
• Review The Quality of Reports on Cervical Arterial Dissection following Cervical Spinal Manipulation
• Describe the Various Mechanisms of Injury in Whiplash Associated Disorders
• Review the Mechanisms of Chronic Pain from Whiplash Injury

• Review methods used by chiropractors to determine the site for applying manipulation
• Review clinical decision rules, spinal pain classification and prediction of treatment outcome in rehabilitation literature
• Describe the trajectories and life course of low back pain
• Discuss the evidence for multisite musculoskeletal pain being common among people suffering from low back pain
• Discuss the relative effectiveness of manipulative therapy vs sham manipulation

• Discuss how spinal manipulation can lead to neural plastic changes involving cortical drive and the H-reflex pathway
• Assess the impact of cervical spinal manipulation on heart rate variability
• Assess how somatosensory evoked potentials (SEPs) can be used to elucidate differences in cortical activity associated with a spinal manipulation (SM) intervention
• Describe alterations in cortical and cerebellar motor processing in subclinical neck pain patients following spinal manipulation
• Apply the effect of spinal manipulation on somato-sympathetic reflexes

• Describe muscle activity patterns in pain development and alleviation
• Discuss the role of anti-inflammatory interventions and their effect on skeletal muscle injury as they pertain to chiropractic examination/treatment
• Assess whether the construct of myofascial pain syndrome caused by trigger points is conjecture
• Review recent fascia research as it pertains to anatomy and biomechanics
• Summarize anatomical and biomechanical properties of fascial tissue with a special focus on fascial dysfunctions and resulting clinical manifestations

• Describe the effect of intervertebral facet joint fixation and segmental thrust level on paraspinal muscle spindle activity
• Determine how contact site for high velocity, low amplitude spinal manipulation affects sensory input to the central nervous system
• Assess the association between low-tech clinical tests commonly used in adult patients with acute, recurrent or chronic LBP and short- and long-term outcome
• Discuss the role for neck manipulation in elderly falls prevention
• Summarize North American chiropractic students’ opinions concerning professional identity, role and future

• Assess whether low back pain (LBP) patients who respond to spinal manipulative therapy (SMT) differ biomechanically from non-responders and untreated asymptomatic controls
• Describe the comparative effectiveness of manipulation versus usual medical care for acute and subacute low back pain
• Determine the effectiveness of adding upper cervical manipulation to a multimodal program for patients with fibromyalgia
• Discuss the effects of forward head posture correction in patients with chronic discogenic lumbosacral radiculopathy
• Summarize US chiropractors' attitudes, skills and use of evidence-based practice

• Review the literature for cases of adverse events in infants and children treated by chiropractors or other manual therapists
• Analyze provider specialties in the treatment of patients with back and joint problems
• Review the role of the cervical spine in post-concussion syndrome
• Assess whether the availability of chiropractic care affects use of primary care physician (PCP) services
• Describe the effect of chiropractic treatment on gastrointestinal (GI) disorders

• Summarize a recent systematic review regarding the use of sacroiliac joint mobility tests
• Determine the prevalence of musculoskeletal dysfunction in patients with chronic pelvic pain
• Explore our current clinical understanding of, and challenges pertaining to, the diagnosis and management of pain in the sacroiliac region
• Evaluate the role of sacroiliac (SI) joint degeneration in mechanical low back pain Investigate and compare typical lumbopelvic movement differences between people with and without low back pain

• Assess the prognostic capabilities of the STarT Back Tool (SBT) and identify pragmatic factors associated with poor outcomes and a transition from acute to chronic low back pain
• Examine the relationship between patients’ pain and functional outcomes over 3-months and their chiropractic visit frequency, visits to other provider types, and other characteristics
• Explore the lived experiences of people with low back pain
• Evaluate the association between depressive symptoms and health outcomes in patients with low back pain
• Quantify the prevalence of facet joint pain in patients with chronic low back pain

• Update the Neck Pain Task Force by providing a best evidence synthesis to determine the reliability and validity of clinical tests used in adults with neck pain and its associated disorders (NAD), specifically those used to assess posture, pain location and cervical mobility
• Evaluate outcomes on seven cervical sensorimotor control tests between patients with chronic idiopathic neck pain and asymptomatic individuals 
• Investigate the association between neck pain and cervical flexion angle during smartphone use (text neck) in adults 
• Rank the effectiveness of physical exercise interventions for chronic non-specific neck pain 
• Compare the effectiveness of adding either instrument-assisted soft tissue techniques or general massage to a therapeutic exercise program for patients with mechanical neck pain and forward head posture

• Identify and describe some of the up-to-date research on chiropractic
• Summarize current research on chiropractic and:
  • neurophysiology
  • chronic spinal pain
  • neck pain and exercise
  • low back pain

• Asses the differences in primary and secondary clinical outcomes between monodisciplinary chiropractic care and multidisciplinary integrative care for sub-acute and chronic low back pain 
• Evaluate the expectations of patients with low back pain and compare these to the assumptions of physicians 
• Compare the efficacy of thrust and non-thrust spinal manipulation in adults with subacute or chronic low back pain
• Describe the prognosis, pain intensity and proportion of participants seeking care following an acute episode of low back pain in a community cohort 
• Investigate the relationship between specific psychosocial factors and severe pain and functional limitation in patients with low back pain

• Identify the impact of financial conflicts of interest on research outcomes: Understand how industry funding can influence the results and interpretations of clinical trials, and differentiate between industry-sponsored and non-industry funded studies.
• Analyze the significance of transparency and disclosure in research: Examine the importance of transparent reporting of financial and non-financial relationships and activities, and assess how perceptions of conflict of interest can be just as crucial as actual conflicts.
• Evaluate emerging approaches to address conflicts of interest: Explore new methodologies, such as Cochrane's guidance, designed to mitigate the risks of bias in research, and critically assess their potential effectiveness in promoting objectivity.
• Apply ethical considerations in research practices: Examine real-world scenarios of potential conflicts of interest in research and apply ethical principles to discern the appropriate course of action, fostering an understanding of how researchers can uphold integrity and impartiality in their work.